We train soldiers for war. Let's train them to come home, too
-
0:01 - 0:02Carlos,
-
0:02 - 0:04the Vietnam vet Marine
-
0:04 - 0:08who volunteered for three tours
and got shot up in every one. -
0:09 - 0:11In 1971, he was medically retired
-
0:11 - 0:13because he had so much
shrapnel in his body -
0:13 - 0:15that he was setting off metal detectors.
-
0:16 - 0:19For the next 42 years,
he suffered from nightmares, -
0:19 - 0:22extreme anxiety in public,
-
0:22 - 0:24isolation, depression.
-
0:24 - 0:26He self-medicated with alcohol.
-
0:26 - 0:29He was married and divorced three times.
-
0:29 - 0:31Carlos had post-traumatic stress disorder.
-
0:32 - 0:36Now, I became a psychologist
to help mitigate human suffering, -
0:36 - 0:40and for the past 10 years, my target
has been the suffering caused by PTSD, -
0:40 - 0:43as experienced by veterans like Carlos.
-
0:43 - 0:49Until recently, the science of PTSD
just wasn't there. -
0:49 - 0:52And so, we didn't know what to do.
-
0:52 - 0:54We put some veterans on heavy drugs.
-
0:54 - 0:57Others we hospitalized
and gave generic group therapy, -
0:57 - 0:59and others still we simply said to them,
-
0:59 - 1:02"Just go home and try to forget
about your experiences." -
1:04 - 1:07More recently, we've tried therapy dogs,
wilderness retreats -- -
1:07 - 1:10many things which may
temporarily relieve stress, -
1:10 - 1:14but which don't actually eliminate
PTSD symptoms over the long term. -
1:15 - 1:16But things have changed.
-
1:16 - 1:22And I am here to tell you
that we can now eliminate PTSD, -
1:22 - 1:23not just manage the symptoms,
-
1:23 - 1:25and in huge numbers of veterans.
-
1:25 - 1:28Because new scientific research
has been able to show, -
1:28 - 1:30objectively, repeatedly,
-
1:30 - 1:34which treatments actually
get rid of symptoms and which do not. -
1:34 - 1:36Now as it turns out,
-
1:36 - 1:41the best treatments for PTSD use
many of the very same training principles -
1:41 - 1:45that the military uses
in preparing its trainees for war. -
1:46 - 1:48Now, making war --
-
1:48 - 1:51this is something that we are good at.
-
1:51 - 1:55We humans have been making war
since before we were even fully human. -
1:56 - 1:59And since then, we have gone
from using stone and sinew -
1:59 - 2:04to developing the most sophisticated
and devastating weapon systems imaginable. -
2:04 - 2:06And to enable our warriors
to use these weapons, -
2:06 - 2:09we employ the most cutting-edge
training methods. -
2:09 - 2:10We are good at making war.
-
2:11 - 2:14And we are good at training
our warriors to fight. -
2:15 - 2:18Yet, when we consider the experience
of the modern-day combat veteran, -
2:18 - 2:21we begin to see that we
have not been as good -
2:21 - 2:23at preparing them to come home.
-
2:23 - 2:25Why is that?
-
2:26 - 2:29Well, our ancestors lived
immersed in conflict, -
2:29 - 2:31and they fought right where they lived.
-
2:32 - 2:35So until only very recently
in our evolutionary history, -
2:35 - 2:38there was hardly a need to learn
how to come home from war, -
2:38 - 2:40because we never really did.
-
2:41 - 2:43But thankfully, today,
-
2:43 - 2:46most of humanity lives
in far more peaceful societies, -
2:46 - 2:50and when there is conflict,
we, especially in the United States, -
2:50 - 2:53now have the technology to put
our warriors through advanced training, -
2:53 - 2:56drop them in to fight
anywhere on the globe -
2:56 - 2:58and when they're done,
-
2:58 - 3:00jet them back to peacetime suburbia.
-
3:01 - 3:04But just imagine for a moment
what this must feel like. -
3:05 - 3:07I've spoken with veterans who've told me
-
3:07 - 3:10that one day they're in a brutal
firefight in Afghanistan -
3:10 - 3:13where they saw carnage and death,
-
3:14 - 3:16and just three days later,
they found themselves -
3:16 - 3:19toting an ice chest
to their kid's soccer game. -
3:20 - 3:23"Mindfuck" is the most common term.
-
3:23 - 3:25(Laughter)
-
3:25 - 3:28It's the most common term
I've heard to describe that experience. -
3:28 - 3:29And that's exactly what that is.
-
3:29 - 3:33Because while our warriors
spend countless hours training for war, -
3:33 - 3:35we've only recently come to understand
-
3:35 - 3:39that many require training
on how to return to civilian life. -
3:40 - 3:44Now, like any training, the best
PTSD treatments require repetition. -
3:44 - 3:45In the military,
-
3:45 - 3:48we don't simply hand trainees
Mark-19 automatic grenade launchers -
3:48 - 3:51and say, "Here's the trigger,
here's some ammo and good luck." -
3:51 - 3:56No. We train them, on the range
and in specific contexts, -
3:56 - 3:58over and over and over
-
3:58 - 4:01until lifting their weapon
and engaging their target -
4:01 - 4:02is so engrained into muscle memory
-
4:03 - 4:05that it can be performed
without even thinking, -
4:05 - 4:08even under the most stressful
conditions you can imagine. -
4:09 - 4:11Now, the same holds
for training base treatments. -
4:12 - 4:15The first of these treatments
is cognitive therapy, -
4:15 - 4:19and this is a kind
of mental recalibration. -
4:19 - 4:21When veterans come home from war,
-
4:21 - 4:23their way of mentally framing
the world is calibrated -
4:23 - 4:26to an immensely
more dangerous environment. -
4:27 - 4:32So when you try to overlay that mind frame
onto a peacetime environment, -
4:32 - 4:33you get problems.
-
4:33 - 4:38You begin drowning in worries
about dangers that aren't present. -
4:38 - 4:41You begin not trusting family or friends.
-
4:42 - 4:46Which is not to say there are no
dangers in civilian life; there are. -
4:46 - 4:49It's just that the probability
of encountering them -
4:49 - 4:50compared to combat
-
4:50 - 4:53is astronomically lower.
-
4:54 - 4:57So we never advise veterans
to turn off caution completely. -
4:57 - 4:59We do train them, however,
to adjust caution -
4:59 - 5:01according to where they are.
-
5:02 - 5:04If you find yourself
in a bad neighborhood, -
5:04 - 5:05you turn it up.
-
5:06 - 5:08Out to dinner with family?
-
5:08 - 5:09You turn it way down.
-
5:10 - 5:13We train veterans to be fiercely rational,
-
5:13 - 5:17to systematically gauge
the actual statistical probability -
5:17 - 5:21of encountering, say, an IED
here in peacetime America. -
5:21 - 5:26With enough practice,
those recalibrations stick. -
5:27 - 5:30The next of these treatments
is exposure therapy, -
5:30 - 5:32and this is a kind of field training,
-
5:32 - 5:36and the fastest of the proven
effective treatments out there. -
5:36 - 5:38You remember Carlos?
-
5:38 - 5:39This was the treatment that he chose.
-
5:40 - 5:42And so we started off
by giving him exercises, -
5:42 - 5:44for him, challenging ones:
-
5:44 - 5:46going to a grocery store,
-
5:46 - 5:48going to a shopping mall,
going to a restaurant, -
5:48 - 5:51sitting with his back to the door.
-
5:51 - 5:52And, critically --
-
5:53 - 5:55staying in these environments.
-
5:56 - 5:58Now, at first he was very anxious.
-
5:58 - 6:00He wanted to sit
where he could scan the room, -
6:00 - 6:02where he could plan escape routes,
-
6:02 - 6:05where he could get his hands
on a makeshift weapon. -
6:05 - 6:08And he wanted to leave, but he didn't.
-
6:08 - 6:11He remembered his training
in the Marine Corps, -
6:11 - 6:13and he pushed through his discomfort.
-
6:14 - 6:17And every time he did this,
his anxiety ratcheted down a little bit, -
6:17 - 6:20and then a little bit more
and then a little bit more, -
6:20 - 6:21until in the end,
-
6:21 - 6:26he had effectively relearned
how to sit in a public space -
6:27 - 6:28and just enjoy himself.
-
6:30 - 6:33He also listened to recordings
of his combat experiences, -
6:33 - 6:35over and over and over.
-
6:36 - 6:40He listened until those memories
no longer generated any anxiety. -
6:40 - 6:43He processed his memories so much
-
6:43 - 6:46that his brain no longer needed
to return to those experiences -
6:46 - 6:48in his sleep.
-
6:48 - 6:52And when I spoke with him
a year after treatment had finished, -
6:52 - 6:53he told me,
-
6:53 - 6:58"Doc, this is the first time in 43 years
-
6:58 - 7:00that I haven't had nightmares."
-
7:01 - 7:06Now, this is different
than erasing a memory. -
7:06 - 7:09Veterans will always remember
their traumatic experiences, -
7:09 - 7:11but with enough practice,
-
7:11 - 7:16those memories are no longer as raw
or as painful as they once were. -
7:16 - 7:20They don't feel emotionally
like they just happened yesterday, -
7:20 - 7:24and that is an immensely
better place to be. -
7:26 - 7:27But it's often difficult.
-
7:28 - 7:31And, like any training,
it may not work for everybody. -
7:32 - 7:33And there are trust issues.
-
7:34 - 7:35Sometimes I'm asked,
-
7:35 - 7:38"If you haven't been there, Doc,
how can you help me?" -
7:38 - 7:39Which is understandable.
-
7:40 - 7:45But at the point of returning
to civilian life, -
7:45 - 7:48you do not require
somebody who's been there. -
7:48 - 7:51You don't require training
for operations on the battlefield; -
7:51 - 7:55you require training on how to come home.
-
7:59 - 8:01For the past 10 years of my work,
-
8:01 - 8:04I have been exposed to detailed accounts
-
8:04 - 8:07of the worst experiences
that you can imagine, -
8:07 - 8:08daily.
-
8:08 - 8:10And it hasn't always been easy.
-
8:10 - 8:13There have been times
where I have just felt my heart break -
8:13 - 8:15or that I've absorbed too much.
-
8:16 - 8:19But these training-based
treatments work so well, -
8:19 - 8:23that whatever this work takes out of me,
it puts back even more, -
8:23 - 8:26because I see people get better.
-
8:27 - 8:29I see people's lives transform.
-
8:31 - 8:34Carlos can now enjoy outings
with his grandchildren, -
8:34 - 8:37which is something he couldn't even do
with his own children. -
8:38 - 8:42And what's amazing to me
is that after 43 years of suffering, -
8:42 - 8:45it only took him 10 weeks
of intense training to get his life back. -
8:46 - 8:48And when I spoke with him, he told me,
-
8:48 - 8:52"I know that I can't get those years back.
-
8:53 - 8:58But at least now, whatever days
that I have left on this Earth, -
8:58 - 9:00I can live them in peace."
-
9:01 - 9:05He also said, "I hope that these
younger veterans don't wait -
9:05 - 9:06to get the help they need."
-
9:07 - 9:08And that's my hope, too.
-
9:09 - 9:10Because ...
-
9:11 - 9:12this life is short,
-
9:13 - 9:17and if you are fortunate enough
to have survived war -
9:17 - 9:19or any kind of traumatic experience,
-
9:19 - 9:22you owe it to yourself
to live your life well. -
9:23 - 9:25And you shouldn't wait
to get the training you need -
9:25 - 9:27to make that happen.
-
9:29 - 9:34Now, the best way of ending
human suffering caused by war -
9:35 - 9:36is to never go to war.
-
9:37 - 9:40But we are just not there
yet as a species. -
9:40 - 9:41Until we are,
-
9:41 - 9:47the mental suffering that we create
in our sons and in our daughters -
9:47 - 9:48when we send them off to fight
-
9:49 - 9:51can be alleviated.
-
9:52 - 9:58But we must ensure that the science,
the energy level, the value -
9:58 - 10:01that we place on sending them off to war
-
10:02 - 10:03is at the very least mirrored
-
10:03 - 10:07in how well we prepare them
to come back home to us. -
10:08 - 10:09This much, we owe them.
-
10:10 - 10:11Thank you.
-
10:11 - 10:18(Applause)
- Title:
- We train soldiers for war. Let's train them to come home, too
- Speaker:
- Hector Garcia
- Description:
-
Hector Garcia speaks at TED Talks Live
- Video Language:
- English
- Team:
closed TED
- Project:
- TEDTalks
- Duration:
- 10:31
![]() |
Brian Greene edited English subtitles for We train soldiers for war. Let's train them to come home, too | |
![]() |
Brian Greene edited English subtitles for We train soldiers for war. Let's train them to come home, too | |
![]() |
Brian Greene approved English subtitles for We train soldiers for war. Let's train them to come home, too | |
![]() |
Brian Greene edited English subtitles for We train soldiers for war. Let's train them to come home, too | |
![]() |
Brian Greene edited English subtitles for We train soldiers for war. Let's train them to come home, too | |
![]() |
Brian Greene edited English subtitles for We train soldiers for war. Let's train them to come home, too | |
![]() |
Camille Martínez accepted English subtitles for We train soldiers for war. Let's train them to come home, too | |
![]() |
Camille Martínez edited English subtitles for We train soldiers for war. Let's train them to come home, too |